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RISS 인기검색어
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- 저자 : Min Huok Jeon (검색결과 4 건)
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Machine-Learning-Based Approach to Differential Diagnosis in Tuberculous and Viral Meningitis
Jeong Young-Seob,Jeon Minjun,Park Joung Ha,Kim Min-Chul,Lee Eunyoung,Park Se Yoon,Lee Yu-Mi,최승임,Park Seong Yeon,Park Ki-Ho,Kim Sung-Han,Jeon Min Huok,Choo Eun Ju,Kim Tae Hyong,Lee Mi Suk,Kim Tark 대한감염학회 2021 Infection and Chemotherapy Vol.53 No.1
Background: Tuberculous meningitis (TBM) is the most severe form of tuberculosis, but differentiating between the diagnosis of TBM and viral meningitis (VM) is difficult. Thus, we have developed machine-learning modules for differentiating TBM from VM. Material and Methods: For the training data, confirmed or probable TBM and confirmed VM cases were retrospectively collected from five teaching hospitals in Korea between January 2000 - July 2018. Various machine-learning algorithms were used for training. The machinelearning algorithms were tested by the leave-one-out cross-validation. Four residents and two infectious disease specialists were tested using the summarized medical information. Results: The training study comprised data from 60 patients with confirmed or probable TBM and 143 patients with confirmed VM. Older age, longer symptom duration before the visit, lower serum sodium, lower cerebrospinal fluid (CSF) glucose, higher CSF protein, and CSF adenosine deaminase were found in the TBM patients. Among the various machinelearning algorithms, the area under the curve (AUC) of the receiver operating characteristics of artificial neural network (ANN) with ImperativeImputer for matrix completion (0.85; 95% confidence interval 0.79 - 0.89) was found to be the highest. The AUC of the ANN model was statistically higher than those of all the residents (range 0.67 - 0.72, P <0.001) and an infectious disease specialist (AUC 0.76; P = 0.03). Conclusion: The machine-learning techniques may play a role in differentiating between TBM and VM. Specifically, the ANN model seems to have better diagnostic performance than the non-expert clinician.
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Primary Hepatosplenic Tuberculosis in an Immunocompetent Adult and Domestic Literature Review
Se Yoon Park,Eun Jung Lee1,Tae Hyong Kim,Jae Young Jang,Min Huok Jeon,Eun Ju Choo,So Young Jin 순천향대학교 순천향의학연구소 2012 Journal of Soonchunhyang Medical Science Vol.18 No.2
Hepatic or splenic involvement of tuberculosis without other disseminated lesions is a very uncommon form of extrapulmonary tuberculosis, especially in an immunocompetent adult. We report a case of a 25 year-old-man who developed primary hepatosplenic tuberculosis not associated with the lung or other distant organs. He was initially diagnosed with esophageal candidiasis in local clinic. A computed tomographic scan of the abdomen showed hepatosplenomegaly and multiple microabscesses in the spleen. Our initial diagnosis, based on the clinical feature and radiologic findings, was hepatosplenic candidiasis. However, histopathology of the liver specimens revealed chronic granuloma with central caseous necrosis, strongly suggestive of tuberculosis. Although rare, splenic tuberculosis should be considered in the differential diagnosis of splenic abscess, especially in countries where tuberculosis is endemic.
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Characteristics of Device-Associated Cerebrospinal Fluid Infection in Adults
So My Koo,Eun Jung Lee,Se Yoon Park,Shi Nae Yu,Min Young Lee,Tae Hyong Kim,Eun Ju Choo,Min Huok Jeon 순천향대학교 순천향의학연구소 2013 Journal of Soonchunhyang Medical Science Vol.19 No.2
Objective: Device-associated infections in the central nervous system are serious complications of procedures involving indwelling devices among neurosurgical patients. In this study, the clinical characteristics and outcome of microbiologically confirmed deviceassociated cerebrospinal fluid (CSF) infection were evaluated. Methods: We performed a retrospective analysis of adult patients found to have a positive CSF culture result during a hospital admission between 1 January 2005 through 2 October 2010 in Soonchunhyang University Hospital. Results: During the study period, all episodes (n=161 CSF specimens, 87 patients) involving a culture-positive CSF were enrolled. Thirty-two episodes of device-associated CSF infection were included in the analysis among the study group. Most device-associated infections were ventriculo-peritoneal shunt infections (14/32, 44%). Fever (>38°C) was present in 17 episodes (53%). Overall, the most common microorganism was coagulase-negative staphylococcus (7/32 [22%]). Gram-negative rods (Pseudomonas aeruginosa 6/32 [19%], Acinetobacter baumannii/haemolyticus 5/32 [16%]) were identified in culture in 16/32 (50%). Device was removed for the control of device-associated infection in 30/32 (94%). Cure rate was 69% (22/32). All patients with treatment failure (10/32, 34%) expired. Conclusion: It is difficult to diagnosis device-associated CSF infections early since those are frequently presented with nonspecific clinical signs and symptoms. In our study, gram-negative infections accounted for 50% of cases and the empiric antibiotics initially chosen were found to not be effective against the final identified pathogen in many cases. Device-associated CSF infections should be strongly considered a serious risk factor associated with CSF infections, and prompt initiation of broad coverage antibiotics should be started after appropriate assessment.
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S-647 Does size matter in therapeutic outcome of tuberculous lymphadenitis?
( Yun Jae Seol ),( Se Yoon Park ),( Shi Nae Yu ),( Tark Kim ),( Eun Jung Lee ),( Min Huok Jeon ),( Eun Ju Choo ),( Tae Hyong Kim ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
Introduction:?There was little data on how lymph node (LN) size is changed during treatment in tuberculous lymphadenopathy (TB LAP). This study aims to provide data on LN changing during treatment.?Methods:?Between Mar 2014 and Dec 2015, 20 patients who were diagnosed with cervical TB LAP were enrolled at the Soonchunhyang University Bucheon Hospital, Bucheon, South Korea. The size of LN was determined by multiplying longest length and breadth. Treatment completion was defined as administration of anti-TB regimens at least 6 months without interruption.?Results:?Of enrolled patients, LN size of eight (40%) patients was 9 cm2 or more. In a half (8/4) of these patients, LN size was increased within 2 month during treatment and 75% (3/4) of patients received LN excision. In 12 patients with LN size less than 9 cm2, only one patient experienced increased LN size during treatment and no one received LN excision. LN was more frequently increased within 2 month (50%, 4/8 vs. 8.3%, 1/12; p=0.04) and excised in patients with initial LN size ≥ 9 cm2 (50%, 4/8 vs. 0%, 0/12; p=0.01).?Conclusions:?In conclusion, initial LN size may be associated with paradoxical response and need of excision during treatment.
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